Content » Vol 49, Issue 8

Original report

Bio-psychosocial factors are associated with pain intensity, physical functioning, and ability to work in female healthcare personnel with recurrent low back pain

Annika Taulaniemi, Lotta Kuusinen, Kari Tokola, Markku Kankaanpää, Jaana H. Suni
The UKK Institute for Health Promotion Research, Tampere, Finland. E-mail:
DOI: 10.2340/16501977-2261


Objective: To investigate associations of various bio-psychosocial factors with bodily pain, physical func-tioning, and ability to work in low back pain.
Design: Cross-sectional study.
Subjects: A total of 219 female healthcare workers with recurrent non-specific low back pain.
Methods: Associations between several physical and psychosocial factors and: (i) bodily pain, (ii) physical functioning and (iii) ability to work were studied. Variables with statistically significant associations (p < 0. 05) in bivariate analysis were set within a generalized linear model to analyse their relationship with each dependent variable.
Results: In generalized linear model analysis, perceived work-induced lumbar exertion (p < 0. 001), multi-site pain (p < 0. 001) and work-related fear-avoidance beliefs (FAB-W) (p = 0. 02) best explained bodily pain. Multi-site pain (p < 0. 001), lumbar exertion (p = 0. 005), FAB-W (p = 0. 01) and physical performance in figure-of-eight running (p = 0. 01) and modified push-ups (p = 0. 05) best explained physical functioning; FAB-W (p < 0. 001), lumbar exertion (p = 0. 003), depression (p = 0. 01) and recovery after work (p = 0. 03) best explained work ability. In bivariate analysis lumbar exertion was associated with poor physical performance.
Conclusion: FAB-W and work-induced lumbar exertion were associated with levels of pain, physical functioning and ability to work. Poor physical performance capacity was associated with work-induced lumbar exertion. Interventions that aim to reduce fear-avoidance and increase fitness capacity might be beneficial.

Lay Abstract

Among people with low back pain in 10% it becomes chronic. Thus, it is important to understand factors influencing the early stages of low back pain. We investigated associations between different physical and psychosocial factors among 219 female health-care workers with recurrent non-specific low back pain. Women with high work-related fear of pain and tiredness at low back after work experienced more pain, and reported lower physical functioning and work ability. Those with low fitness level experienced more lumbar tiredness.
In clinical practise, assessing fear-avoidance believes and levels of work-induced lumbar exertion might help in targeting preventive measures such as back counselling and exercise to tackle the risk of prolonged low back pain.

Related articles


Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors. You need to login/create an account to comment on articles. Click here to login/create an account.